Provider Demographics
NPI:1073721809
Name:ALBERTO, KEZIA JASMINA RIBEIRO (MD)
Entity Type:Individual
Prefix:DR
First Name:KEZIA
Middle Name:JASMINA RIBEIRO
Last Name:ALBERTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:153 PASSAIC AVE
Mailing Address - Street 2:
Mailing Address - City:ROSELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07068-1106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:83 HANOVER RD
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1508
Practice Address - Country:US
Practice Address - Phone:973-736-2212
Practice Address - Fax:973-736-2989
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08278900207R00000X, 208M00000X
NJMA082789207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0142972Medicaid
NJ114702TS6Medicare PIN